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Organization

LEG UP FARM, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LOUIS CASTRIOTA JR. (PRESIDENT & CEO)
(717) 266-9294
Entity
Organization

Contact information

Practice address
4880 N SHERMAN STREET EXT, MOUNT WOLF, PA 17347-9637
(717) 266-9294
(717) 384-8071
Mailing address
4880 N SHERMAN STREET EXT, MOUNT WOLF, PA 17347-9637
(717) 266-9294
(717) 384-8071

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
PA
221700000X
Art Therapist
224Z00000X
Occupational Therapy Assistant
225100000X
Physical Therapist
225200000X
Physical Therapy Assistant
225A00000X
Music Therapist
225X00000X
Occupational Therapist
Primary
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023981110001
PA
Enumeration date
10/30/2009
Last updated
05/12/2010
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